Provider Demographics
NPI:1487726600
Name:ZOLLINGER, CLINTON (MPT)
Entity type:Individual
Prefix:
First Name:CLINTON
Middle Name:
Last Name:ZOLLINGER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9460 N NAME UNO
Mailing Address - Street 2:140
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3537
Mailing Address - Country:US
Mailing Address - Phone:408-847-0107
Mailing Address - Fax:408-847-2112
Practice Address - Street 1:9460 N NAME UNO
Practice Address - Street 2:140
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3537
Practice Address - Country:US
Practice Address - Phone:408-847-0107
Practice Address - Fax:408-847-2112
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist